Rapid assessment of platelet inhibition using a modified whole blood aggregometer (aggrestat™) in PTCA patients receiving ReoPro™

Mascelli, Mary Ann; Lance, Ellen T.; Mack, Sabina; Weisman, Harlan F.; Schalble, Thomas; Jordan, Robert E.

doi:10.1016/s0735-1097(96)82361-8

Cited by 4 publications

(3 citation statements)

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“…The data for phase II correlated with the manufacture's recommendations for the concentrations ' of collagen (2)(3)(4)(5) u.g/m! ), ADP (5-20 ~tM), arachidonic acid (0.5-l .C1 m~, and ristocetin (O.f~3--i .2m g/ml).…”

Section: Discussionmentioning

confidence: 55%

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Evaluation of Whole-Blood Lumiaggregation

Podczasy

Lee

Vučenik

1997

Clin Appl Thromb Hemost

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An evaluation of whole-blood lumiaggregation was conducted in a normal population. Platelet aggregation and adenosine triphosphate (ATP) secretion were monitored in a three-phase study that analyzed sample dilution, agonist dose response, and method comparison. In the first phase, the blood:saline ratio was varied; in the second phase, the concentration of the agonists was varied ; and in the last phase, a comparison of impedance aggregation and ATP release in whole blood to optical aggregation and ATP release in platelet-rich plasma (PRP) was performed. Five common platelet agonists— collagen, adenosine diphosphate (ADP), arachidonic acid, thrombin, and ristocetin—were used in this evaluation of the lumiaggregometer (Chrono-Log Corp., Havertown, PA, U.S.A.). The data revealed that the optimum blood:saline ratio for conducting platelet antigen studies is 1:1, although with some agonists other dilutions can be used. The agonist dose-response phase basically confirmed the manufacturer's concentration recommendations. Additionally, it was determined that platelet aggregation using the whole-blood impedance technique compared to the PRP optical method yielded similar information. Furthermore, the advantages of whole-blood impedance aggregation include its use in microsamples and more timely results due to minimal sample preparation.Platelet function tests are performed to ascertain disorders of platelet function, to evaluate patients treated with antiplatelet medications, and to characterize various cardiovascular diseases ( ~-3). Histoically, platelet aggregation studies have utilized platelet-rich plasma (PRP) and the turbidimetric technique of Born (4) for assessing platelet function. The preparation of PRP is time-consuming and requires specimen handling during the centrifugation process, which may alter the activation status of these cells. Aggregation studies measure platelet aggregation optically in which the intensity of transmittance is proportional to platelet aggregation.The measurement of platelet function in whole blood using impedance (electrical resistance) technology (5) has the advantage of monitoring platelet aggregation and dense granule secretion simultaneously in a physiologic whole-blood environment, without the centrifugation and specimen handling required to produce PRP. In the whole-blood lumiaggregometer, when the platelets are exposed to agonists, they aggregate on the surface of electrodes that are immersed in a sample containing platelet. In this instrument, platelet function can be measured by platelet aggregation in whole blood using collagen, archidonic acid, adenosine diphosphate (ADP), ristocetin, and thrombin as the agonists. Thrombin is the most potent agonist known, and when used at a concentration of 1.0 U/mi it induces the secretion of all the platelet-dense granules independently of cyclooxygenase and thromboxane A2 formation. In contrast, platelet secretion to arachidonic acid is dependent upon thromboxane A2. Aggregation to the agonist collagen is dependent upon t...

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Section: Discussionmentioning

confidence: 55%

“…For collagen, ADP, and arachidonic acid, platelet aggregation and ATP secretion (Figs. [3][4][5] induced by these agonists increased slightly over the concentration ranges studied. When thrombin was used as the agonist, the data demonstrated a steady increase in ATP release (Fig.…”

Section: Resultsmentioning

confidence: 86%

Evaluation of Whole-Blood Lumiaggregation

Podczasy

Lee

Vučenik

1997

Clin Appl Thromb Hemost

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“…Several other methods are currently available to assess platelet function, such as bleeding time [10] or turbidimetric methods [11), but both of them are labor-intensive, occasionally not reproducible, and not always easily interpreted. A recently evaluated method, rapid platelet function assay (RPFA) (Accumetrics, San Diego, CA), has been reported to predict platelet aggregability in patients treated with GP IIb/IIIa receptor blockers and has been shown to compare favorably to the standard aggregation methods [12,13]. However, the results obtained with this device are only interpretable when a baseline test is obtained prior to the administration of antiplatelet therapy, and the unit used (PAU) is not easily interpretable.…”

Section: Discussionmentioning

confidence: 99%

Use of ICHOR‐platelet works to assess platelet function in patients treated with GP IIb/IIIa inhibitors

Lakkis

George

Thomas

et al. 2001

Cathet Cardio Intervent

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Platelet glycoprotein GP IIb/IIIa inhibitors have been recently approved for use in treating patients with acute coronary syndromes and those undergoing PCI. The purpose of this study was to assess the feasibility of using a new device, the ICHOR platelet works, to detect platelet inhibition in patients undergoing PCI and treated with abciximab or tirofiban. The study was conducted at Baylor College of Medicine, Houston, Texas. Thirty patients undergoing PCI and treated with abciximab (n = 10) or tirofiban (n = 20) are included. Blood samples were obtained before, at 30 min, at 4 hr, and at 12 hr after starting the GP IIb/IIIa inhibitors and 2 hr after discontinuation. Baseline studies revealed > 95% platelet aggregability in all patients after exposure to ADP (20 microM). After starting tirofiban, 82%, 83%, and 82% of platelets were inhibited at 30 min, 4 hr, and 12 hr. Platelet inhibition decreased to 43% 2 hr after discontinuation of tirofiban. Similarly, ICHOR platelet works detected 91%, 92%, and 85% platelet inhibition at 30 min, 4 hr, and 12 hr after starting abciximab, respectively. Platelet inhibition decreased to 73% 2 hr after discontinuation. The ICHOR platelet works is a promising, simple, and rapid bedside method that may have clinical utility in assessing platelet inhibition in patients treated with GP IIb/IIIa inhibitors. Cathet Cardiovasc Intervent 2001;53:346-351.

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Anticoagulation Monitoring for Percutaneous Transluminal Coronary Angioplasty

Ferguson¹,

Wilson²

Developments in Cardiovascular Medicine

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Rapid assessment of platelet inhibition using a modified whole blood aggregometer (aggrestat™) in PTCA patients receiving ReoPro™

Cited by 4 publications

References 0 publications

Evaluation of Whole-Blood Lumiaggregation

Evaluation of Whole-Blood Lumiaggregation

Use of ICHOR‐platelet works to assess platelet function in patients treated with GP IIb/IIIa inhibitors

Anticoagulation Monitoring for Percutaneous Transluminal Coronary Angioplasty

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